Total knee arthroplasty in hemophilic arthropathy

Legroux-Gérot, Isabelle; Strouk, G.; Parquet, A.; Goodemand, Jenny; Gougeon, F.; Duquesnoy, B

doi:10.1016/s1297-319x(02)00008-8

Cited by 36 publications

(41 citation statements)

References 20 publications

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“…Reports of total knee replacement (TKR) in patients with haemophilia using factor concentrates date back to the 1970's (Marmor, 1977). Over time, advances in orthopaedic surgery and postoperative care have improved the outcome of TKR (Legroux-Gerot et al, 2003). Pain relief can be achieved in the vast majority of patients who undergo TKR, but improvements in postoperative ROM are more variable (Small et al, 1983;Beeton et al, 2000;Legroux-Gerot et al, 2003).…”

Section: Joint Arthroplastymentioning

confidence: 99%

“…Over time, advances in orthopaedic surgery and postoperative care have improved the outcome of TKR (Legroux-Gerot et al, 2003). Pain relief can be achieved in the vast majority of patients who undergo TKR, but improvements in postoperative ROM are more variable (Small et al, 1983;Beeton et al, 2000;Legroux-Gerot et al, 2003). Factors which may influence the ROM outcome include soft tissue contracture, stage of joint deterioration, type of prothesis, and postoperative mobilisation (use of a continuous passive motion machine or manipulation under anaesthesia) (Beeton et al, 2000).…”

Section: Joint Arthroplastymentioning

confidence: 99%

“…However, despite these improvements in pain and functional mobility, TKR in haemophilia has been hampered by a high-complication rate. Complications include postoperative haemarthrosis, peroneal nerve palsy, wound infection, joint sepsis and prothestic loosening (Legroux-Gerot et al, 2003). The frequency of these complications varies, but infection has been the single biggest problem.…”

Section: Joint Arthroplastymentioning

confidence: 99%

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Modern management of haemophilic arthropathy

2007

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SummaryCurrently available factor concentrates for treatment of patients with haemophilia are virally inactivated or are made by recombinant technology and their broad use in developed nations has resulted in the dramatic elimination of the treatment‐related viral illnesses that decimated the haemophilia community in the late 20th century. The major morbidity experienced by patients with haemophilia today is joint disease, a result of repeated bleeding episodes into joint spaces. Although administration of factor concentrates to prevent bleeding has been demonstrated to prevent haemophilic joint disease when applied assiduously, repeated bleeding episodes induce synovitis that is irreversible and may progress despite subsequent prophylaxis. Surgical and nuclear medicine interventions are available to reduce the pain of haemophilic arthropathy and to reduce further bleeding episodes. Patients with high titre inhibitors are at great risk for the development of joint disease and present the greatest therapeutic challenges when joint surgery is needed.

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Section: Joint Arthroplastymentioning

confidence: 99%

Section: Joint Arthroplastymentioning

confidence: 99%

Section: Joint Arthroplastymentioning

confidence: 99%

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Modern management of haemophilic arthropathy

2007

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“…Arthrodesis and arthroplasty are invasive orthopaedic procedures typically reserved to manage end‐stage joint disease symptoms such as pain and limitation of function . Thus, it would be expected to have an older (>20 years) population undergo these types of procedures.…”

Section: Discussionmentioning

confidence: 99%

Risk factors associated with invasive orthopaedic interventions in males with haemophilia enrolled in the Universal Data Collection program from 2000 to 2010

et al. 2018

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“…Multiple surgical interventions have been utilized to treat hemophiliac arthropathy in the knee, with total knee arthroplasty (TKA) becoming a safe and successful option for end-stage hemophiliac arthropathy 6). TKA is the most common procedure in hemophiliacs 7).…”

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confidence: 99%

Total Knee Arthroplasty in Hemophiliacs: Gains in Range of Motion Realized beyond Twelve Months Postoperatively

et al. 2012

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BackgroundHemophiliacs have extrinsic tightness from quadriceps and flexion contractures. We sought to examine the effect of a focused physical therapy regimen geared to hemophilic total knee arthroplasty.MethodsTwenty-four knees undergoing intensive hemophiliac-specific physical therapy after total knee arthroplasty, at an average age of 46 years, were followed to an average 50 months.ResultsFor all patients, flexion contracture improved from -10.5 degrees preoperatively to -5.1 degrees at final follow-up (p = 0.02). Knees with preoperative flexion less than 90 degrees were compared to knees with preoperative flexion greater than 90 degrees. Patients with preoperative flexion less than 90 degrees experienced improved flexion (p = 0.02), along with improved arc range of motion (ROM) and decreased flexion contracture. For those patients with specific twelve-month and final follow-up data points, there was a significant gain in flexion between twelve months and final follow-up (p = 0.02).ConclusionsHemophiliacs with the poorest flexion benefited most from focused quadriceps stretching to a more functional length, with gains not usually seen in the osteoarthritic population. This data may challenge traditional views that ROM gains are not expected beyond 12-18 months.

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Total knee arthroplasty in hemophilic arthropathy

Cited by 36 publications

References 20 publications

Modern management of haemophilic arthropathy

Modern management of haemophilic arthropathy

Risk factors associated with invasive orthopaedic interventions in males with haemophilia enrolled in the Universal Data Collection program from 2000 to 2010

Total Knee Arthroplasty in Hemophiliacs: Gains in Range of Motion Realized beyond Twelve Months Postoperatively

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